Laserfiche WebLink
. <br />< <br />' APPLICATI�N FOR CONSTRUC' .ON <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />■ <br />� <br />PERMIT � <br />BUILDING DEPARTMENT . HEATING SY,c,TEM: U GAS ❑ ELECTRIC 0 <br />259•8810 <br />❑ DEMGLITION f_l COMBINATION � BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />OWNEH MAILADDRESS , CITY I�p pHONE <br />mru�ni �IMIL�OUPE55 �Q(� CITY ZIP PMONE . � � <br />S�tmE <br />�HCHITECTOfl�E51GNFR MAILADOfiE55 CITY ZIP PHONE . <br />SNM 6 <br />GENEMICONTMCTOR MAILAUDflESS Gi�: 21P PNONE STATELIGENSEI <br />SAMrr <br />MECHANICALCONTRACTOfl MAIL ADDRE55 CITY ZIP PHONE _TATE LICENSE � <br />PLUTABIN(iGONTfiACTOfi MAILAODRESS GITY 21P PHONE STATELICENSE� <br />lASS OF WOflK <br />. NEW ❑ ADDITION ❑ ALTERATION f.] REPAIR ❑ OEMOLITION 17 WOODSTOVE/FRPL INSERT i! HUILDING PELOCATIQN <br />//`� GONTACT PERSON AND PHONE NO. � �,/� (�/ <br />CONTMCTPRICEOFWORK ✓ ({;jJ7 > J�� � � %JuN/-�Ti ��S�G1p'J� <br />DESCflIBE WOflK AND SOUARE Fp'a^AGE INVOL� <br />1 i� J <br />PROPOSED USE OF BUILOING <br />�RRRGE <br />LEGAL �ESCRIPTION OF PROPI <br />LOT BIOCK <br />�EV�R�Y AC <br />c- <br />TVPE <br />WATER CLUS <br />iTY �SHOWN BELOW OF ATfACH FW H COPIES) <br />OF <br />2� A.6E •TRA C.T S <br />�-oa - W. 150 �T. <br />I�Ess �'. go. 8 � r. <br />�owtR R �pGE RoAD <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVEN' <br />ROOF DRAINS—RAIN <br />SINK ISERVICE-8AR <br />' SL <br />PE <br />_ TC <br />FOR OFFiCE USE CNLY: <br />FflONTSETBACK REARSETBACN <br />Zo � ZO � <br />USEZONE LOTMEA <br />.. <br />ttPE OF CONTS. �LLOWP9LE IYPE OF CONST. RCiOA <br />- -N <br />SIZEOFBLOG. � � NO.OFSTORIES <br />sf <br />OCCUPANCY �LOAD FIRE SPRNHLEHS fll <br />flEA50NFOR5PflINKLEflS �� <br />INTN(E8Y PLANSAPPROVEDE <br />� <br />VAGrW T SITE <br />pCWPANCY NOOfVMIIINGUNiIS <br />GxWP � <br />BASEMENT <br />MEIGNTLIMITATI N / <br />� <br />CITY OF EVERETT <br />LOCALSALES <br />TAl( CODE IS 3105 <br />� HEREBY CEFiTIFY THAT I HAVE READ AND EXAMINED TH13 <br />APPLICATION AN� KNOW TNE SAME TO BE TRUE AND CORflECT. ALL <br />PROVISIONS AF LAWS AND ORDINANCES GOVERNING TNIa TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPEC�FIcD HEREIN OP, <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNEfl OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTOflS LAW 18.27 RC ND 296.200 WAC. <br />�� ��� �� <br />uAE OAiE <br />NO. <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />WOOD STOVE <br />METAL FIREPLACE 8 <br />HEAT <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />ADDITIONAL PLAN CHECK <br />SPRINKLER <br />STATE BUILDING SURCHARGE <br />PUBLIC WORKS <br />TOTAL <br />-B.T.U. M E.A. <br />M <br />SVB TOTAL $ <br />PcRMIT $ <br />TDTALFEE $ <br />�O <br />RECEIP NO. <br />� � � �0,�� <br />7, <br />i <br />i <br />0 <br />